Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Division of Endocrinology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Box 54, Chicago, IL, 60611, USA.
Curr Diab Rep. 2019 Nov 21;19(12):143. doi: 10.1007/s11892-019-1267-6.
This review will focus on the long-term outcomes in offspring exposed to in utero hyperglycemia and gestational diabetes (GDM), including obesity, adiposity, glucose metabolism, hypertension, hyperlipidemia, nonalcoholic fatty liver disease, and puberty.
There is evidence, mostly from observational studies, that offspring of GDM mothers have increased risk of obesity, increased adiposity, disorders of glucose metabolism (insulin resistance and type 2 diabetes), and hypertension. In contrast, evidence from the two intervention studies of treatment of mild GDM and childhood measures of BMI, adiposity, and glucose tolerance do not demonstrate that GDM treatment significantly reduces adverse childhood metabolic outcomes. Thus, more evidence is needed to understand the impact of maternal GDM on offspring's adiposity, glucose metabolism, lipid metabolism, risk of fatty liver disease, and pubertal onset. Offspring of GDM mothers may have increased risk for metabolic and cardiovascular complications. Targeting this group for intervention studies to prevent obesity and disorders of glucose metabolism is one potential strategy to prevent adverse metabolic health outcomes.
本文将重点关注宫内高血糖和妊娠期糖尿病（GDM）暴露对后代的长期影响，包括肥胖、脂肪含量、糖代谢、高血压、血脂异常、非酒精性脂肪肝和青春期。
有证据表明，主要来自观察性研究，GDM 母亲的后代患肥胖症、脂肪含量增加、糖代谢紊乱（胰岛素抵抗和 2 型糖尿病）和高血压的风险增加。相比之下，两项关于轻度 GDM 治疗和儿童 BMI、脂肪含量和葡萄糖耐量的干预研究的证据表明，GDM 治疗并不能显著降低儿童不良代谢结局的风险。因此，需要更多的证据来了解 GDM 对后代肥胖、糖代谢、脂代谢、脂肪肝风险和青春期开始的影响。GDM 母亲的后代患代谢和心血管并发症的风险可能增加。针对这一人群进行干预研究以预防肥胖和糖代谢紊乱是预防不良代谢健康结局的一种潜在策略。
